Interleukin-6 bedside testing in women at high risk of preterm birth
Nicola Vousden1, Manju Chandiramani, Paul Seed
1Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College London School of Biomedical and Health Sciences, London, United Kingdom. nicola.vousden@kcl.ac.uk
Objective:
Infection is likely to contribute to preterm birth (PTB). Laboratory analysis has demonstrated that vaginal IL-6 is correlated with PTB. We aimed to investigate a bedside test in this context.
Method:
Vaginal secretions were collected from 71 asymptomatic high-risk women. After 20 minutes incubation at room temperature, samples were analyzed by the bedside reader (IL-6 concentration in pg/ml) (Milenia-Biotec, Germany). Maternal and neonatal infectious markers and pregnancy outcome were recorded.
Results:
IL-6 was related to PTB, latency to gestation and maternal infection but not neonatal infection. In women with visible fetal membranes (n = 13), all of those with a high IL-6 (≥56 pg/ml) had a PTB (n = 11) compared to half (n = 1) with a low IL-6 (<56 pg/ml). All the women with a high IL-6 at <24 weeks' (n = 10) delivered before viability compared to none with a low IL-6 (n = 2). In women with preterm prelabor rupture of membrane (PPROM) and high IL-6 (n = 8) there was a trend toward more extreme PTB's (57% vs. 0%, p = 0.19) and delivery within 7 days (71% vs. 50%, p = 0.09) compared to low IL-6 (n = 5).
Conclusion:
IL-6 may be useful in guiding the difficult management of patients with visible membranes and PPROM, for example, the potential benefit of a cervical cerclage.
